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Obama's Preventative Care talking point: No, actually it won't save money, and won't encourage prevention

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Posted on August 19 2009 1:50 pm
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The sound and fury of the health care debate centers around the public option, to be sure. But there are other issues, lurking below the surface, that might turn out to be the iceberg to Obamacare’s Titanic.

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A lifeboat full of Blue Dog Democrats is seen here pulling away from the foundering S.S. ObamaCare.

Barack Obama, in an op-ed article for the New York Times, stated:

“Most important, we will require insurance companies to cover routine checkups, preventive care and screening tests like mammograms and colonoscopies … It makes sense, it saves lives and it can also save money.”

Preventative care is one of Obama’s big talking points when he claims his health care overhaul will save money. Just one problem—it won’t.

David Brooks, interviewed by NewsHour with Jim Lehrer, came out and said it – preventative care will not save the government money. And last night on CNN’s Campbell Brown, Politifact.com’s Bill Adair confirmed just that. Said Adair:

“Indeed, the Congressional Budget Office came out with a report last week that said that indeed preventive care is more costly, because, if you think about it, to find the people who might be prone to heart disease or diabetes, you have to test a lot of people who may not be prone.  And so those costs add up.”

That’s simple logic. Take, for example, cancer. According to the American Cancer Society, there are an estimated 1.5 million cancer cases in America. To catch all of those cases early would require testing the entire population of America regularly. It might save some costly chemotherapy or radiation treatments down the line, and it would probably save lives, but it wouldn’t save money.

But let’s face it, not everyone is going to get tested. How can we be sure? Because even many people whose health insurance covers routine exams, colonoscopies, or mammograms don’t get those tests done. Many don’t remember. Many are afraid and don’t want to hear the bad news, if and when it comes.

There lies a vast gulf between providing the opportunity for preventative care, and providing preventative care itself. Even if the government offers free preventative measures for every person in America, they cannot force women over 40 to call and schedule a mammogram. The individual woman knows, gets literature from her doctor and her friends, and knows that she should get that mammogram. But unless she makes it a priority and goes in and has it done, all the government provisions in the world cannot make her take care of herself.

Look at lifestyle choices that almost inevitably lead to higher health care costs–people know that cigarettes and tobacco products are terrible for their health, and while they may complain about higher taxes on their self-proclaimed nasty habit, they still buy ’em and light up. People know that they should exercise 3 times a week for 30 minutes, and yet not everyone finds the time to exercise after they get home from work between the 2 hours of mindless TV and the 3 hours of browsing Facebook every night before they go to bed (not that we have ever done this…).

Preventative health must be a choice. Take obesity. Americans are fat — according to the American Heart Institute, over 140 million of us are overweight or obese. Do we have consensus on that? OK, good. We’re told time and time again that obesity leads to all kinds of problems–from back and knee pain to diabetes and heart disease. Yet no one forces anyone to eat doughnuts, just as no one is sitting next to citizens forcing them to eat a salad. Then, when Average Joe or Jane American suddenly develops knee pain or trouble breathing, they don’t want to be told, “Well, if you lost about 50 pounds your knee probably wouldn’t hurt and you could breathe easier.” They want a quick fix, a prescription for the latest FDA-approved treatment for Knee-Breathlessness Syndrome.

Our point is this: preventative care is all well and good, but much of it cannot be mandated, because so much of what causes health issues are personal choices. Even when it comes to cancer and diabetes, a person must take responsibility for his or her own health to get the checkups they need.

In the novella The New Atlantis by Ursula K. Le Guin, the author posits a dystopian future government so oppressive that it has managed to get the John Birch Society and the Weather Underground to work together. In the story, one of the main characters is injured. The character doesn’t want to go to a government hospital, but soldiers burst into her apartment and take her away at gunpoint to enforce her “right to health care.”

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"It's time for your appointment..."

What often frustrates the Left more than anything is that they cannot force individuals to act the way they want them to. (We will note that this wrong-headed tendency is often shared by the more moralistic right as well, and is often just as effective at changing behavior.) Unless the left is willing to empower a government to go the full “New Atlantis,” rounding people up with guns and forcing them to get colonoscopies and other routine examinations, they are going to have to live with the fact that the biggest hindrance to catching breast cancer and prostate cancer on the front end is not predatory insurance companies or evil lobbyists, but individuals who won’t take care of themselves.

This is why we need more individual choice in health care–more consumer options, not more government mandates. With the individual in charge of his or her own health care options, there is a much greater incentive to seek preventative care and stay healthy than if the government in essence says, “sure, get preventative care, but if you don’t we’ll make sure all your expenses are covered anyway.” We can’t make people be responsible, but we can at least foster an environment that encourages rather than discourages responsibility.

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